The usual response I receive when I tell friends that I am going to Colombia, South America on a medical mission, is that of wide-eyed incomprehension followed by “are you safe there?” Granted, Colombia has a notorious past of violence and sophisticated drug trafficking organizations, some of which still plague areas of the country. The health care inequities are prolific among a confusing and changing health system. Nonetheless, Colombia has stolen my heart.
As a Family Practice Nurse Practitioner, I volunteer both clinically and as a board member with the organization “Living Abundantly Using Guided Helping Hands” (LAUGHH). The LAUGHH foundation (laugh.org) is a grassroots, all volunteer organization, founded with a mission to serve the underserved through education and life skills. After one of the founding members, a native Colombian, expressed a desire to help her country, the LAUGHH medical mission to Colombia was born.
From the beginning we were determined to make this more than a “feel good mission”. Our focus is on self-empowerment of patients through knowledge regarding their own health care needs. Preventive care and chronic disease self-management education is the core of our mission. In this way, we create sustainable health improvement techniques to improve lives. For the past 4 years, LAUGHH has established a relationship with the Colombian government to enhance primary and preventive care services for underserved areas. We travel as a group of some 80 U.S. and Colombian volunteers by bus into rural areas, evaluating patients throughout the life span in makeshift primary care clinics. Our group consists of doctors, nurses, physical therapists, nutritionists, and translators, as well as volunteers who just “help get stuff done”. Central to the evaluation, is the education of patients on self-management of chronic disease and health promotion. In Colombia, as in the U.S., diabetes and hypertension are prevalent. All patients receive diet and exercise education, as well as individualized learning on hypertension and diabetes. The focus on the educational aspect enhances the patient experience and bridges an education gap in what is often a very fragmented health care experience for rural patients. With low literacy rates, we work to educate on basic lifestyle changes and use graphic educational materials. We call ourselves the “mission within the mission” because although patients are evaluated by a physician and usually receive a small supply of medicine, our real goal is knowledge and self-management techniques of the things that patients have control over.
Our acceptance by the Colombian government and the people of Colombia has been amazing. We now have native Colombian physicians accompanying us on our mission. We also have medical students assisting our doctors and providers, both as translators of the language and culture and in assisting in the medical history. The students also conduct education sessions and have learned the “teach-back” method of patient education. As young medical student put it – “In medical school we learn to diagnose and treat a patient. LAUGHH has shown us how to care for our patients”. What can be more affirming to an organization than that?
LAUGHH is growing and expanding their imprint in rural Colombia. In the 4 years LAUGHH’s inception, governmental relationships and community trust has been strengthened, which has extended the reach of the organization. We have forged relationships with native Colombians in a way that was impossible to envision in the beginning. For one week each year, we blend as a cohesive team and as a result, I have made many new friends. My new friends have shown me that Colombia is a magnificent country. It has beautiful mountains and a beautiful coastline. It is home to some of the most diverse birds and butterflies in the world. Their coffee is arguably the best, and each year when I return to Colombia, it is the first thing I seek out is a good cup of jo. But more than anything, my new friends have shown me that they are proud of their country and what the future holds for them. Colombians want their name spelled right. Perhaps that is why the people of Colombia will quickly point out any spelling indiscretion by claiming “Por favor, es Colombia no Columbia”